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Dr.Niraj Mahajan
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Laparoscopy

By AdminPosted On 05-Oct-2016

1. Pneumoperitoneum


Gas preferred for creating pneumoperitoneum during laparoscopy is


a) carbon dioxide

b) oxygen

c) air

d) nitrous oxide

e) Helium

Correct Answer: a) Carbon dioxide.

CO2 is the most widely used peritoneal distention medium, largely because of rapid absorption of CO2 in blood. O2 can not be used as it helps in combustion and most of the time electrosurgery commonly called as cautery is used. NO2 is insoluble in blood.

Reference – Novak’s Gynecology


2. Veress Needle


What is the most serious risk associated with the insertion of a Veress needle through the umbilicus in a thin patient?


a) Bowel perforation

b) Damage to liver

c) Damage to ureters

d) Inferior epigastric artery injury

e) Vascular injury


Correct Answer: e) Vascular injury. The aorta, inferior vena cava and common iliac arteries are put at risk with the insertion of the Veress needle. The open entry technique is considered to be safer in this matter. The risk of bowel damage is not completely avoided using the open entry technique.

The common iliac artery arises from the aorta on the left side of the fourth lumbar vertebra and divulges acutely. The inferior vena cava lies behind the right common iliac vessel. In a thin patient, the major blood vessels are only a few centimetres away and are particularly at risk with a Veress entry.


3. Thoracoscopic Surgery


In Video assisted thoracoscopic surgery for better vision the space in the operative field is created by


a) Co2 insufflation

b) Collapse of ipsilateral lung

c) Self retaining retractor

d) Rib spacing

Correct Answer: b) Collapse of ipsilateral lung. Lung deflation on the side of the chest where VATS is being performed is effected with a double-lumen endo-tracheal tube that allows for single lung ventilation or a bronchial blocker delivered via a standard single-lumen endotracheal tube. Unlike with laparoscopy, carbon dioxide insufflation is not generally required with VATS due to the inherent vault-like shape of the thoracic cavity.



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Dr. Niraj Mahajan

MD- Gynecologist, Laparoscopic Surgeon, Uro-gynecologist , Infertility specialist & Cosmetic Gynecologist.

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